Author: Mary Beth Howard

Hot Seat #154: Denouement

The case: a 16mo with concern for foreign body aspiration Here’s how you answered the questions: Discussion: The features that make this case interesting: 1. Multiple consulting services with differing takes on management (and which service is going to be responsible for taking this thing out?) and 2. A scary x-ray finding in a very […]

Hot Seat #151. Denouement

The case: 8 yo M coughing up blood with overall normal exam and normal labs. Here’s how you answered the questions: Less than 3 years PEM experience differential:-Tonsilitis-Occult Airway trauma-Infection (TB aspergillosis)-Mass-ALL-Bleeding/clotting disorder-Foreign Body-AVM-Vasculitis More than 3 years PEM experience differential:-Upper GI bleed/ulcer-Pulmonary Infection-Mass-Bleeding/clotting disorder-Foreign Body-AVM-ALL-TB-Vasculitis Discussion: The differential for this otherwise healthy child coughing […]

Hot Seat #150: Denouement

The case: a 13 yr old girl with a vulvar abscess requiring surgical I&D, found to be trichomonas positive. Here’s how you answered the questions: Discussion: This case raises both ethical and medical dilemmas. From an ethical stand point, we have a young post-pubertal girl presenting with a sexually transmitted infection. While concerning, most would […]

Hot Seat #149: Denouement

The case: a 9mo healthy boy presenting with fever and great toe redness concerning for cellulitis vs osteomyelitis. Here’s how you answered the questions:   Discussion: In a child who looks sick, most would obtain initial blood work, including blood culture, CBC ,and inflammatory markers. For imaging for this patient, most would also obtain an […]

Hot Seat #149: 9 mo w fever and toe redness

CC: 9mo male with fever and toe redness HPI: 9mo otherwise healthy boy presents with acute onset fever and great toe redness. Per mother, great toe was noted to be red and swollen at daycare about 2 hrs prior to presentation. She did not notice it in the morning when getting him dressed. When mother […]